Happy birthday, Avestria!
Looking at the past, present, and future as Avestria turns two
It’s official — Avestria Ventures is two years old!
Avestria Ventures Fund I had its first close on July 9, 2019. Now, on July 9, 2021, we’re looking at the past, present, and future of the company, including why Avestria was originally founded and what we’re anticipating over the next few years.
Looking Back:
Prior to starting Avestria, the company’s co-founders, Harvard Business School classmates Linda Greub and Corinne Nevinny, were already veterans in the industry; they had held executive management and investing roles in both healthcare and the life sciences. Linda had spent over 30 years investing in public and private life science companies as an institutional investor, a corporate M&A executive, a hedge fund analyst, and a private venture investor. Corinne, a pioneering female executive, had held C-Suite roles at both Edwards Life Sciences and Tularik (which was acquired by Amgen).
In 2010, their shared backgrounds and interests in healthcare, investing, and female entrepreneurship inspired them to start investing their own capital, along with a third partner, in female-founded businesses.
One of those businesses was nVision Medical, which was co-founded and led by Surbhi Sana. Surbhi had developed a solution that allowed physicians to detect and treat ovarian cancer in its early stages before it metastasized, spread to other parts of the body, and became increasingly fatal. Despite the high fatality rate of ovarian cancer and the potential of her solution to help mitigate it, Surbhi noticed that men, who compose almost 90% of investment decision-makers in the venture capital industry, were often outside their comfort zone, especially when she started discussing or showing pictures of the female anatomy as part of her pitch for her B round. Some of those VCs even told her directly, “Oh. This is a women’s issue,” as if women — half of the population — were not a significant enough market to merit an investment.
The data, though, shows that both female entrepreneurs and women’s health are productive investment opportunities. Female-led businesses have been shown to perform better than all-male teams across various metrics: for example, they generate $.78 revenue per dollar raised whereas all-male teams generate $.31 per dollar, and they also have 35% higher ROI and 63% higher valuation than male-led teams do. Yet, about 2.3% of all venture capital funding went to female-founded companies in 2020: down from an all-time-high of about 2.8% in 2019. (For Black female founders, the 2020 percent is 0.64%.)
Healthcare, meanwhile, is a $4T industry dominated by women. They compose 80% of the healthcare workforce, make 80% of healthcare decisions for their household, and consume 80% of all pharmaceuticals — yet PitchBook data shows that women’s healthcare companies consistently receive less than $400M annually in private funding.
In 2018, after Boston Scientific acquired nVision for up to $275 million, Linda and Corinne realized that women’s health and female entrepreneur-led life science ventures were huge opportunities that the male-dominant investment community were overlooking and undervaluing. In 2019, in order to support those entrepreneurs and fuel those innovation, they launched Avestria Ventures.
Now:
In the two years since Avestria was founded, the company has grown its team, invested in thirteen portfolio companies, seen two exits (Alydia Health and Uqora), and closed its first fund. Through all the corresponding conversations, events, meetings, investments, and pitches, here are the top three lessons that we’ve learned.
- Fundraising is difficult.
This lesson probably shouldn’t have taken us by surprise given the research: first-time fund managers have a harder time raising capital than previously-established ones. Being a first-time fund manager who is a woman and/or a minority is yet another obstacle that can hamper fundraising efforts since white males still manage about 99% of the total $69 trillion asset management industry.
Diversity can bring incredible value to funds. A study published in the Harvard Business Review found that VC firms that increased the number of female partners by 10% experienced a 1.5% increase in fund returns each year and 9.7% more profitable exits than firms that didn’t bring in female partners. PitchBook fund performance data also shows that 69% of the venture firms that scored a top-quartile fund between 2009 and 2018 had women in decision-making roles.
But women are still often shut out of male-dominated VC firms. From 2015 to 2020, the number of female-founded VC firms nearly quadrupled because women are now starting their own VC firms to have the power needed to make investment decisions.
Starting a VC firm from scratch, though, means that its founders are usually classified as “emerging managers” because they don’t have prior experience leading a fund. In fact, 90% of all women-led funds are considered emerging managers.
While emerging managers can have equal or greater returns than established firms, they don’t have the long-term record and asset size that institutional investors require. The cycle then perpetuates: first-time fund managers have a hard time raising the capital they need to increase their assets under management and to establish a track record, both of which are necessary to help them raise capital in the first place.
Avestria is one of those emerging managers. Despite the subsequent challenges when fundraising, we’ve learned — and continue to remind ourselves—to trust in our expertise when it comes to making investments, and to believe that our portfolio companies will have exits that will continue to improve our track record and will entice LPs to be part of our next closes.
2. Networks are key.
Since Avestria was founded, the team has emphasized its industry experience and networks as some of its core differentiating factors. Over the past two years, we’ve seen the benefit of those connections over and over again.
Our networks, from our official advisors to friends to general connections in healthcare and investment, have been invaluable. They have shared their expertise, offered advice on fundraising, introduced us to current portfolio companies, connected us to sources that help with our due diligence, and given us the chance to be featured in articles, panels, and more.
Colleagues at other VC firms have also helped us experience one of the best parts of being in venture capital: the collaboration. We count ourselves extremely lucky to have friends in venture capital who are willing to keep in touch, make introductions, bring us into deals, and simply offer advice regarding the many logistics that come with founding and running a fund (or, really, any other type of business).
3. There are many, many promising investments in women’s health companies.
When fundraising, we’ve heard not only that women’s health is a niche market but also that it’s a limited one. If there are great deals in women’s health— people have asked us — why haven’t they already been funded?
Simply put: female entrepreneurs are at a disadvantage when pitching to mostly men, as Linda and Corinne saw with Surbhi and nVision — and women are more likely to start women’s healthcare companies than men are. Women, after all, have been the ones whom healthcare has historically excluded, degraded (especially if they’re Black), and reduced to small men.
In short, to answer those who ask us this question: just because those companies haven’t received investment due to the de-prioritization of female entrepreneurship and women’s health doesn’t mean that they weren’t worthy of investment in the first place — and it certainly doesn’t mean that women’s health is a limited market.
We’ve actually found the opposite to be true. Since Avestria started, we’ve screened almost 1,000 potential portfolio companies — nearly all of which would have been promising investments — that are filling white spaces in women’s healthcare, including those in Alzheimer’s, cardiovascular health, diabetes, cancer, and osteoporosis among others. In the process, those companies are underlining our thesis that the opportunities for innovation and subsequent investment in women’s health are numerous — but that a change in the current investment system needs to occur so that the value of women’s health can be fully recognized.
Looking Forward:
Like we did in 2019, we think that women’s health and female-led life science ventures are on the cusp of major innovation, investment, and growth — and we’re already starting to see signs that our belief is shared.
For some examples: the U.S Department of Health and Human Services announced an initiative at the end of 2020 to improve maternal health, an increasing number of startups and VCs are addressing the menopause market, and a possible side effect of the coronavirus vaccines has left women asking why that same side effect is still a common one of birth control.
We’ve seen various funds and groups — including (but not limited to) FemTech Collective, FemTech Focus, FemTech Insider, Springboard Enterprises, the Women’s Health Innovation Coalition and Women of Wearables focused on raising awareness and supporting female founders as well as founders, investors, and advocates of “femtech” and women’s health. Organon, a global women’s health company that officially launched as an independent company on June 3, 2021, has promised to give women the microphone. (Organon also acquired Alydia Health, which was an Avestria portfolio company and our first exit in Fund I).The number of female-founded unicorns is growing and, within the past few months alone, female-founded firms, like Bumble and Figs, have had successful IPOs and showed the power of having women in leadership roles.
As the ecosystem continues to grow, as women entrepreneurs continue to succeed, and as women’s health gets the attention and respect that it deserves, everyone can benefit: VCs can help make introductions or attract other investors to deals, female entrepreneurs and women’s health companies can get the funds they need to support their innovations, and those innovations, in turn, can help save lives and improve healthcare around the world.
In conclusion, as we reflect on the past and plan for the future, we’re thankful to all of those who have helped us come to our two year anniversary, we’re hopeful about the future of the venture capital and healthcare industries, and we’re looking forward to the connections, collaborations, and companies that await us as Avestria heads into its next year — and all the years that follow.
At Avestria Ventures, we look for early-stage women’s health and female-led life science companies with products or technologies that improve healthcare quality and/or access, lower costs, induce clinical or behavioral change, are evidence based, have scalable commercialization plans, and have a sustainable competitive advantage. Know one? Contact us via our website, LinkedIn, or Twitter.
